Ueda Hiroki, Nakagawa Tsuyoshi, Sato Takanobu, Nagahara Makoto, Sugihara Kenichi
Dept. of Surgery, Soka Municipal Hospital, Japan.
Gan To Kagaku Ryoho. 2012 Nov;39(12):2068-70.
We report the case of a 60-year-old female with liver dysfunction resulting from diffuse liver metastases, which, atypically, had originated from breast cancer. She responded remarkably well to trastuzumab monotherapy. She was referred to our hospital because of left breast cancer with multiple general lymphadenopathies. She presented with jaundice and liver dysfunction without a space-occupying lesion or a dilatation of the intrahepatic bile duct on computed tomography images. A liver biopsy was done to rule out autoimmune hepatitis, primary biliary cirrhosis, or primary sclerosing cholangitis, and histopathological examination showed adenocarcinoma in the lymph duct of the liver. Both the primary breast cancer and the liver metastases were negative for hormone receptor expression(ER-, PR-), but overexpressed HER2(HercepTest 3+). She was diagnosed as invasive ductal carcinoma(T1N3cM1, Stage IV). We started trastuzumab monotherapy, which improved her jaundice and liver dysfunction, and resulted in a decrease in lymph node size.
我们报告一例60岁女性,因弥漫性肝转移导致肝功能不全,非典型的是,肝转移源自乳腺癌。她对曲妥珠单抗单药治疗反应显著良好。她因左乳腺癌伴多处全身淋巴结肿大被转诊至我院。她表现为黄疸和肝功能不全,计算机断层扫描图像上未见占位性病变或肝内胆管扩张。进行了肝活检以排除自身免疫性肝炎、原发性胆汁性肝硬化或原发性硬化性胆管炎,组织病理学检查显示肝淋巴管内为腺癌。原发性乳腺癌和肝转移灶的激素受体表达均为阴性(雌激素受体阴性、孕激素受体阴性),但人表皮生长因子受体2过度表达(赫赛汀检测3+)。她被诊断为浸润性导管癌(T1N3cM1,IV期)。我们开始曲妥珠单抗单药治疗,这改善了她的黄疸和肝功能不全,并导致淋巴结大小减小。